A 7 year old child has signs and symptoms such as abnormally high fever(102 up to about 105), respiratory distress, severe headache, sluggishness, muscle aches and weakness. Say mid day Sunday the symptoms begin, on Monday morning the parent takes child to the Emergency Room, and later that day is released from the hospital with Pneumonia as a diagnosis and sent home with antibiotics. Within 48 hours the temperature never goes below 103 and the child never responds to antibiotics. Between 46-48 hours after discharge the mother takes the child back to the Emergency Room demanding blood work and more test. Within 24 hours they in fact diagnosed the child with Viral Meningitis. The child is now in the hospital for a 10 day observation and requires physical therapy because her equilibrium is off due to the high fever consistent for so long. I've read up on negligence malpractice and misdiagnosis but am not sure which this case falls under.
I, myself am a cousin to the infected child here and just want to apply what I've learned in my Healthcare Law & Ethics to this situation. The 4 D's of negligence are present but I am having trouble chosing if this is actually mis-diagnosis or just flat out negligence. I don't have the total story from my cousin's case and I guess every detail is imperative.
By the way, on the person that said it could have been the mother at fault for waiting so long, she had been in touch with the triage and Ask a nurse line there at the hospital and she was told to wait until 48 hours to ensure antibiotic was in her system. [which could affect the outcome with this information because this health care worker advised to wait a set amount of time before bringing her back in, she may be the one at fault in this case? or not?]
Truthseeker
A misdiagnosis can be a basis for a malpractice suit. Not every misdiagnosis results in a case of malpractice. Malpractice is just another term for negligence: Which means breach of a duty because of failure to exercise due care and as a result of this breach harm or injury occurred.
A physician has a duty to exercise due care in diagnosing a patient. This is the biggest hurdle you need to overcome. You have duty, you have harm. Your problem is could other physicians or a reasonable physician under same or similar circumstances could have misdiagnosed. If the answer is yes, there is no breach. This is what a jury decides, usually after listening to expert testimony. You may want to consult a local malpractice lawyer, it may be worth it.
Stuart
Presented with the symptoms you describe, I'd probably have looked at pneumonia as a possible diagnosis also.
The meningitis is rare enough that it would not typically be on the radar as a possibility unless there was evidence of insect bites, also.
I don't want to second guess the ER staff, but I'd have probably tried antibiotics from the get-go, too.
Misdiagnosis, and one that anyone could make.
- Stuart
randomperson
I would consider this misdiagnosis. The all the symptoms match to pneumonia and the child wasn't experiencing any symptoms that would single out menigitis such as stiff neck,rash,etc. Most doctors would probably assume pneumonia first because it is much more common than viral meningitis. We don't say doctors practice medicine because it sounds nice, it is often trial and error to diagnosis people correctly. Since his reasoning wasn't completely off and the child wasn't seriously harmed by something the doctor did it would call it misdiagnosis.
Another thing i thought of, it is really the mothers fault, not the doctor, the child had to undergo physical therapy due to her high fever. 48 hours is way too long to wait if the fever is at 103, for a 7 year old kid, she probably should have got back in touch within a day at most of it not going down.
The nurse could definitely be the one at fault here but I'm no healthcare professional so i can't definitely say if she was actually wrong in what she told her to do. I am surprised a nurse told her to wait for that long though considering how young your cousin was and how long she had the high fever already though. If you really want a answer you would probably have to ask another doctor what he thinks and get all the facts.
Orignal From: Tips: is this malpractice or misdiagnosis?
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